on grounds of mis-representation, fraud, non-disclosure of material facts, the policy shall stand cancelled ab-initio and Pre-Policy Check-up Grid there will be no refund of premium. In the event the policy is terminated on grounds of non-cooperation of the insured or If you terminate the Policy, the premium shall be computed in accordance with Our short rate table for the period the Age (Years) Sum Insured (Rs.) Sum Insured (Rs.) Sum Insured (Rs.) Policy has been in force, upon 30 days notice by sending an endorsement to Your address shown in the Schedule 2 Lacs 3 Lacs, 4 Lacs & 5 Lacs 7.5 Lacs, & 10 Lacs provided no claim has occurred up to the date of termination. In the event a claim has occurred in which case there shall be no return of premium. 18-50 Nil Nil LEVELl 2 - ME, RUA, FBS, ECG • Portability: A policy holder desirous of porting (shifting) his policy to us shall apply at least 45 days before the premium 51-55 LEVEL 1 - ME, FBS, ECG LEVEL 4 - ME, RUA, FBS, LEVEL 4 - ME, RUA, FBS, renewal date of his existing policy. The accrued benefits and time bound exclusions will also be transferred without any ECG, CBC, TC CBC, ECG, TC interruption. Portability will be provided in accordance to IRDA guidlines issued from time to time. • Tata AIG understands your need to buy a policy basis your life stage and therefore we offer you an option to migrate to 56-60 LEVEL 2 - ME, RUA, FBS, LEVEL 3 - ME, RUA, FBS, LEVEL 5 - ME, RUA, FBS, CBC, similar health insurance Policy with Us and certainly at the time of renewal only, provided that you are covered under ECG CBC, Lipids, ECG Lipids, SGOT, TMT, HbA1c, Sr this policy as a dependant and are at the end of specified exit age. You will be offered continuity of coverage & suitable Creat, PSA (males), USG credits, if any, for all the previous policy years, provided the policy has been maintained without a break. abd(females) • In the event of revision / modification of the product, you will be informed 3 months before the expiry of the policy. You will have the option to either continue with such modified product or migrate to similar health insurance policy available 61-65 LEVEL 6 - ME, RUA, FBS, LEVEL 7 - ME, RUA, FBS, LEVEL 8 - ME, RUA, FBS, CBC, with us at the time of renewal with all the accrued continuity benefits. CBC, Lipids, TMT, SGOT, CBC, Lipids, TMT, SGOT, Lipids, TMT, LFT,RFT HbA1c, Section 41 of Insurance Act 1938 (Prohibition of rebates): Total Proteins, Sr Creat, PSA Total Proteins, Sr Creat, PSA PSA (males), USG Abd (1) ”No person shall allow or offer to allow either directly or indirectly as an inducement to any person to take out or renew (males), USG Abd (females) (males), USG Abd (females) or continue an insurance in respect of any kind of risk relating to lives or property in India, any rebate of the whole or (females),HbA1c part of the commission payable or any rebate of premium shown on the policy, nor shall any person taking out or renewing or continuing a policy accept any rebate, except such rebate as may be allowed in accordance with the Note: ME = Medical Examination (Report), CBC = Complete Blood Count, ECG = Electro Cardio Gram, FBS = Fasting Blood published prospectus or tables of the insurers”. Sugar, Lipids = Lipid Profile, Sr Creat = Serum Creatinin, PSA = Prostate Specific antigen, RUA = Routine Urine Examination, (2) If any person fails to comply with sub regulation (1) above, he shall be liable to payment of a fine which may extend to TMT = Treadmill Test, USG = Ultrasonogram, SGOT - Serum Glutamic Oxaloacetic Transaminase, HbA1c - Glycoslated rupees five hundred. Hb, TC - Total Cholesterol, RFT= Renal function test, LFT = Liver function test. Test levels 1 to 4 will be paid fully by Tata AIG, however for test levels 5 to 8; 50% costs to be paid by the proposed insured to specified diagnostic centers and the rest 50% will be paid by Tata AIG. If any additional tests are required then 50% of the costs will be paid by the proposed insured to the specified diagnostic centres. In case of a decline; the refund of premium will be done after deducting the remaining 50% of medical test cost. Basis the Pre Policy Check-Up, medical underwriting will be 24x7 Toll Free Help Line 24x7 Claims Helpline carried out. If you are required to undergo Pre Policy Check-Up, you must carry your photo ID (Original and a photocopy) to Highlights 1800 425 4090 (Toll Free) Write to us MediPrime the network diagnostic centre. The medical reports are valid for a period of 90 days from the date of PPC. 1800 209 2001 to choose 10 reasons [email protected] More than * For Senior Citizens For Senior Citizens ettlement* ely claim s Ease of tim Terms and Conditions 1800 229 966 040-23552899 1. 2. Cashless facility across a strong and wide • Entry age is 18 years to 65 years for the proposer. The premium rates mentioned in the premium table for age network of hospitals across India# Above 66^ years are only for renewal cases. This is only a summary of the product features. The actual benefits available are as described in the policy and will be subject 3. Lifelong renewal*** • Waiting Period: Policy coverage starts 30 days from the 1st inception of the policy (except accident). Any listed to the policy terms, conditions and exclusions. Comprehensive coverage illnesses / treatments will be covered after a waiting period of 24 months. Any pre-existing condition will be 4. Disclaimer: Insurance is the subject matter of the solicitation. For more details on benefits, exclusions, limitations, terms and Non-allopathic treatment covered after a waiting period of 48 months. 5. conditions, please read sales brochure/policy wordings carefully, before concluding a sale. No sub-limits on inpatient hospitalization • In MediPrime, you can insure yourself, your spouse, upto 3 dependent children (aged between 91 days to 21 years) and 6. The benefits and features of the products and services are purely indicative in nature. The purchase of a Tata AIG General expenses your dependent parents. -pay applicable across any of the benefits Insurance Company Limited product by Axis Bank Limited customers is purely on a voluntary basis. For clarifications, 7. No co • You can cover a maximum of 5 family members (upto a maximum of 2 adults and 3 children under a single customers can call on 1800 201 2009 or write to [email protected]. payable MediPrime family floater policy) and 7 members under individual policy. 8. Nil loading on renewal premium, in case of a • We may apply a risk loading on the premium payable based upon the declarations made in the proposal form and the Axis Bank Limited is a Licensed Corporate Agent (CA license no. 1891411) of Tata AIG General Insurance Company Limited claim (IRDA registration no.108). The insurance products are underwritten by Tata AIG General Insurance Company Limited ('Tata health status of the person proposed for insurance. The maximum overall risk loading shall not exceed 150% per 9. Tax savings under section 80D##-up^^, person. We will issue policy only after getting your consent in case of risk loading. AIG'), having its registered office at Peninsula Corporate Park, Tower A, 15th Floor, Ganpatrao Kadam Marg, Lower Parel, 10. Loyalty benefits like health check • You have a period of 15 days from the date of receipt of the Policy document to review the terms and conditions of this Policy. If Mumbai 400 013. This information is given by Axis Bank Limited ('Axis Bank') whose registered office is at 'TRISHUL', Third cumulative bonus^^^ Floor, Opp. Samartheshwar Temple, Nr. Law Garden, Ellisbridge, Ahmedabad 380006. You have any objections to any of the terms and conditions, You have the option of cancelling the Policy stating the reasons 11. You can port your existing policy at the for cancellation and You will be refunded the premium paid by You after adjusting the amounts spent on any medical check- time of renewals as per our policy terms Tata AIG General Insurance Company Limited up, stamp duty charges and proportionate risk premium. You can cancel Your Policy only if You have not made any claims and conditions Registered Office: Peninsula Business Park, Tower A, 15th Floor, G. K. Marg, Lower Parel, Mumbai- 400013. under the Policy. All Your rights under this Policy will immediately stand extinguished on the free look cancellation of the er 2 / AXB - Cobra 158

Policy. Free look provision is not applicable and available at the time of renewal of the Policy. TAGIC/B/ME/Nov 13/5 V • Your Policy is lifelong renewable, unless fraudulent or any misrepresentation.Renew within the due date to ensure renewal benefits like cumulative bonus, coverage for pre-existing diseases and health check-up. Your renewal premium will be basis your revised age band and there will be no extra loadings based on your individual claim.You can renew your policy within 30 days from the expiry of the policy. Tata AIG • All applications for renewal must be received by Us before the end of the Policy Period. If the application for renewal Visit us at: and the renewal premium has been received by Us before the expiry of the Policy Period, We will ordinarily offer renewal terms for life unless, We believe that You or any Insured Person or anyone acting on Your behalf or on MediPrime behalf of an Insured Person has acted in an improper, dishonest or fraudulent manner or any misrepresentation under or in relation to this Policy or the renewal of the Policy poses a moral hazard or non- cooperation by the insured. • We may at any time terminate this Policy on grounds of misrepresentation, fraud, non-disclosure of material facts or Best Product Innovation Award non-cooperation by You or any Insured Person or anyone acting on Your behalf or on behalf of an Insured Person by # sending an endorsement to Your address shown in the Schedule to this Policy. In the event of termination of this Policy #Please refer our website for complete details The Indian Insurance Awards 2013 Health Emergencies come without any advance notice, which you will not be able to prevent but you can X. Emergency Ambulance: The policy covers expenses incurred for utilizing ambulance service upto MediPrime Annual Premium Table including Service Tax & Education cess @12.36% ( All figures in ` ) certainly prevent it from becoming a financial burden on you and your family. Tata AIG understands this Rs. 2,500 per hospitalisation. need and brings to you MediPrime, an open, transparent and comprehensive medical insurance without XI. Portability: A policy holder desirous of porting (shifting) his policy to us shall apply at least 45 days Premium table: Individual MediPrime: Family Floater sub-limits so that you can focus on your family’s recovery without any financial worry. SI Age 10,00,000 7,50,000 5,00,000 4,00,000 3,00,000 2,00,000 Age before the premium renewal date of his existing policy. The accrued benefits and time bound 1 Adult + 1 Child Group Oldest* exclusions will also be transferred without any interruption. Portability will be provided in accordance Key Benefits 0-17 3,982 3,787 3,533 3,252 3,026 2,872 Member 10,00,000 7,50,000 5,00,000 4,00,000 3,00,000 2,00,000 to IRDA guidelines issued from time to time. 18-35 7,369 6,952 6,215 4,966 3,831 3,387 18-35 9,413 8,905 8,083 6,815 5,817 5,368 a) Settlement of your claims**: We settle your claims hassle-free and quickly so that you can focus on 36-45 9,314 8,787 7,856 6,276 4,740 4,221 36-45 11,027 10,427 9,444 7,902 6,689 6,104 quality and timely recovery rather than managing the funding of the treatment, subject to submission of Choose to renew with us and avail of the following incentives if you haven’t claimed: 46-50 15,076 14,221 12,709 10,153 8,149 6,878 46-50 16,523 15,605 14,035 11,470 9,443 8,222 all required documents. 1. Cumulative Bonus^^^: We appreciate you renewing your policy with us and in appreciation You get 51-55 20,046 18,909 16,898 13,499 10,833 8,883 51-55 21,440 20,235 18,134 14,634 11,863 10,035 b) Network of hospitals#: We are equipped to offer you quality health care in your city with our strong a Cumulative Bonus of 10% for every claim-free year accumulating up to 50%. In case of claim during 56-60 23,264 21,944 19,610 15,666 12,570 10,340 56-60 24,443 23,063 20,646 16,594 13,385 11,306 network of 3000+ hospitals across India. Kindly carry original photo identity proof along with cashless the policy year, the bonus Sum Insured if any will get reduced by 10% at the time of renewal. 61-65 36,716 34,631 30,945 24,721 19,832 16,862 61-65 38,930 36,728 32,861 26,370 21,272 18,289 card to avail cashless hospitalization in network hospitals. 66-70^ 50,501 47,633 42,557 33,997 27,272 21,693 66-70^ 51,541 48,623 43,485 34,857 28,078 22,708 2. Get a Health Checkup done^^: Your health is our concern too and to appreciate your renewed faith in >70^ 59,604 56,218 49,845 39,818 31,940 24,045 >70^ 59,869 56,477 50,151 40,182 32,349 24,860 c) Lifelong renewal***: We offer you a lifelong renewal for your policy provided premium is paid without us, we offer a health check-up up to 1% of the Sum Insured per Policy subject to a maximum of any break Your premiums will be basis the age and coverage. Your renewal premium will be basis your Rs. 5,000 per Insured Person once at the end of a block of every continuous four claim free years. revised age band and there will no extra loadings based on your individual claim. Annual Premium Table MediPrime: Family Floater Annual Premium Table MediPrime: Family Floater 3. Sum Insured Enhancement – Sum Insured can be enhanced only at the time of renewal subject to no Age Age 1 Adult + 2 Children 1 Adult + 3 Children d) Optional Two years Term: The longer term option of two years policy is more convenient and claim have been lodged/ paid under the policy. If you choose to increase the sum insured one grid up, Oldest* Oldest* economical as we offer a discount* on the premium no fresh medicals shall be required. In cases where the sum insured increase is more than one grid up, Member 10,00,000 7,50,000 5,00,000 4,00,000 3,00,000 2,00,000 Member 10,00,000 7,50,000 5,00,000 4,00,000 3,00,000 2,00,000 e) Tax Savings##: If one purchases a health insurance policy for self /spouse/children, he/she can claim a the case shall be subject to medicals. In case of increase in the Sum Insured waiting period will apply 18-35 12,441 11,785 10,774 9,307 8,147 7,582 18-35 15,134 14,348 13,172 11,536 10,239 9,572 36-45 14,020 13,275 12,106 10,371 9,001 8,302 36-45 16,660 15,787 14,458 12,564 11,063 10,268 tax deduction of upto Rs. 15,000. When one purchases a health insurance policy for parents (a senior afresh in relation to the amount by which the Sum Insured has been enhanced. However the quantum 46-50 19,927 18,834 17,014 14,121 11,825 10,475 46-50 22,703 21,473 19,466 16,352 13,874 12,430 citizen), he/she is eligible for an additional tax deduction benefit upto Rs. 20,000. Tax benefit under of increase shall be as per underwriting guidelines of the company. 51-55 25,416 23,998 21,560 17,550 14,358 12,378 51-55 28,562 26,980 24,294 19,936 16,456 14,374 section 80D of Income Tax Act 1961. Tax benefits are subject to changes in tax laws. 56-60 28,756 27,141 24,334 19,665 15,946 13,698 56-60 32,248 30,446 27,336 22,204 18,102 15,735 Indicative list of documents for claims Salient Features of MediPrime 61-65 43,174 40,741 36,495 29,409 23,842 20,673 61-65 46,446 43,839 39,314 31,808 25,910 22,619 (1) Signed Claim Form (2) First consultation letter and subsequent prescription (3) Original detailed 66-70^ 55,517 52,383 46,893 37,716 30,504 24,999 66-70^ 58,368 55,083 49,357 39,831 32,344 26,797 I. In- patient hospitalization including room rent, ICU, nursing, medicines drugs & consumables covered discharge card (4) Day care summary from the hospital (5) Original Bills / Receipts from Hospital / Medicines >70^ 63,668 60,071 53,418 42,928 34,685 27,106 >70^ 66,241 62,509 55,659 44,865 36,382 28,831 without any sub-limits. / Investigations / Implants and any other document as required for processing claim (6)Original Photo II. Pre and Post Hospitalization medical expenses: Expenses incurred upto 30 days immediately before identify proof along with the cashless card. Annual Premium Table MediPrime: Family Floater Annual Premium Table MediPrime: Family Floater hospitalization and upto 60 days immediately after discharge are covered. The coverage period can be Age Age 2 Adults 2 Adults + 1 Child extended upto 60 days before hospitalization & 90 days after discharge by submitting relevant Oldest* Oldest* Contact details for claims documents to us 5 days or more in advance from the date of hospitalization. Member 10,00,000 7,50,000 5,00,000 4,00,000 3,00,000 2,00,000 Member 10,00,000 7,50,000 5,00,000 4,00,000 3,00,000 2,00,000 18-35 12,204 11,515 10,297 8,229 5,899 5,328 18-35 15,173 14,340 12,941 10,691 7,733 6,886 III. Day Care Procedures: The policy covers medical expenses for 140 different day care treatments which Family Health Plan (TPA) Ltd. Claims Department, Tata AIG General Insurance Company Limited (Tata AIG), Ground Floor, Srinilaya – Cyber Spazio, Road No: 2, Banjara Hills, Hyderabad Pin : 500 034. 36-45 14,831 13,992 12,510 9,994 7,158 6,390 36-45 17,744 16,764 15,107 12,418 8,930 8,091 do not require 24 hours hospitalization. 46-50 25,185 23,776 21,338 17,298 14,129 12,292 FHPL Toll Free Number: 1800 425 4090 46-50 21,737 20,505 18,328 14,642 11,754 10,054 IV. Domiciliary Treatment: The policy covers for the medical expenses incurred for availing medical 51-55 29,595 27,916 24,949 19,931 15,996 13,252 51-55 33,631 31,735 28,412 22,841 18,470 15,558 treatment at home which would otherwise have required Hospitalisation. 56-60 35,910 33,873 30,271 24,182 19,405 15,982 56-60 40,129 37,860 33,869 27,155 21,887 18,287 Key Exclusions 61-65 61,155 57,692 51,594 41,333 33,275 28,277 V. Organ Donor: The policy covers In-patient medical expenses incurred on the insured (i.e. recipient) and 61-65 57,142 53,898 48,163 38,475 30,868 26,029 66-70^ 83,729 78,983 70,612 56,525 45,459 37,035 the organ donor for harvesting (i.e. surgery & storage of organ) and for organ transplantation. Intentionally self-inflicted Injury or illness; Conditions related to or arising out of HIV; AIDS; War; Congenital 66-70^ 80,205 75,650 67,593 53,997 43,317 34,976 anomalies; Pregnancy and all related conditions; Abuse of drugs and alcohol and addiction or overdose etc. >70^ 1,01,279 95,526 84,858 67,788 54,378 41,679 >70^ 1,04,356 98,437 87,511 70,024 56,285 43,596 VI. Accidental Dental Treatment: The policy covers inpatient coverage upto 100% of Sum insured and Please refer to policy wordings for complete list of detailed benefits and exclusions available on outpatient treatment upto Rs 5,000 for sum insured between 2lacs to 4lacs and upto Rs. 7,500 for sum www.tatataiginsurance.in Annual Premium Table MediPrime: Family Floater Annual Premium Table MediPrime: Family Floater insured between 5lacs to 10lacs. Age Age 2 Adults + 2 Children 2 Adults + 3 Children Oldest* Oldest* VII. Ayush Benefit: The policy covers you for medical expenses incurred for In-patient treatment taken Premiums and Discounts under Ayurveda, Unani, Sidha or Homeopathy, upto Rs. 20,000 for sum insured from 2lacs to 4lacs and Member 10,00,000 7,50,000 5,00,000 4,00,000 3,00,000 2,00,000 Member 10,00,000 7,50,000 5,00,000 4,00,000 3,00,000 2,00,000 18-35 17,774 16,816 15,265 12,874 9,253 8,455 upto Rs. 25,000 for sum insured from 5 lacs to 10 lacs per policy year. • Premium rates are for a one year policy. Premium are subject to change with prior approval from IRDA. 18-35 20,090 19,016 17,295 14,676 10,873 9,998 36-45 20,256 19,157 17,357 14,542 10,686 9,719 36-45 22,573 21,357 19,388 16,344 12,306 11,262 • The premium under individual and floater coverage will be charged on the completed age of the VIII. Daily Cash for Accompanying an Insured Child: If the insured person hospitalized is a child aged 46-50 27,938 26,391 23,763 19,494 16,141 14,210 46-50 30,255 28,591 25,793 21,296 17,761 15,753 individual insured member and the age of the oldest insured member respectively between 12 years or less, we will pay a daily cash of Rs. 300 per day & maximum upto Rs. 9,000 per 51-55 36,730 34,670 31,094 25,155 20,493 17,480 51-55 39,047 36,870 33,125 26,957 22,114 19,022 hospitalization for sum insured from 2 lacs to 4 lacs & Rs. 500 per day & maximum upto Rs. 15,000 per • *Get a 10% family discount on individual plans if 3 or more family members are covered. 56-60 43,382 40,938 36,661 29,504 23,888 20,183 56-60 45,699 43,138 38,691 31,306 25,508 21,726 hospitalization for sum insured from 5 lacs to 10 lacs. • *Get an additional 5% discount on premium by choosing a 2 year term 61-65 63,964 60,351 54,016 43,397 35,058 29,991 61-65 66,281 62,551 56,046 45,199 36,678 31,533 IX. Vaccination for Animal bite treatment: The policy covers Inpatient coverage upto 100% of sum insured 66-70^ 85,767 80,915 72,384 58,070 46,826 38,449 66-70^ 88,084 83,115 74,415 59,873 48,446 39,992 and outpatient treatment upto Rs. 5,000 per policy year >70^ 1,05,689 99,704 88,706 71,108 57,282 44,786 >70^ 1,08,006 1,01,904 90,736 72,911 58,902 46,328